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Macular vitreoretinal interface abnormalities in highly myopic eyes with posterior staphyloma: 5-year follow-up.
Retina. 2012 Sep; 32(8):1531-8.R

Abstract

PURPOSE

To review prevalence, long-term progression, and prognosis of vitreoretinal interface modifications in pathologic myopia with posterior staphyloma and investigate foveal sensitivity and fixation stability.

METHODS

Retrospective single-institution series of 214 eyes (116 patients) with pathologic myopia, axial length >30 mm, and posterior staphyloma. Exclusion criteria included follow-up less than five years, incomplete records, and/or less than three optical coherence tomography or microperimetry. Patients were divided into 5 groups according to optical coherence tomography: 1) epiretinal membrane without schisis (ERM); 2) macular retinal schisis (Schisis); 3) partial thickness macular hole (PTMH); 4) full-thickness macular hole (FTMH); and 5) posterior retinal detachment (PRD) with or without macular hole. Disease progression was defined as a visual acuity decrease of two or more lines associated to objective worsening of the optical coherence tomography and/or microperimetry.

RESULTS

Vitreoretinal abnormalities at baseline were present in 116 of 204 patients (56.8%) and 214 of 408 eyes (52.4%); 98 of 116 patients (84.4%) showed bilateral involvement. Baseline visual acuity and foveal sensitivity varied significantly with ERM performing better and PRD worse than others; PTMH and FTMH did not differ. During the 66 months of average follow-up, 33 of 214 eyes (15.4%) required surgery and 13 of 33 eyes (39.3%) needed reintervention. Surgery rate significantly differed among groups: 2% for ERM, 20% to 25% for Schisis, PTMH, and FTMH, and up to 50% for PRD. Progression rate of Schisis and FTMH was the same, regardless of symptoms, while macula-off PRD always required surgery. Decrease of fixation stability and foveal sensitivity correlated to need for surgery, while baseline foveal sensitivity and fixation did not.

CONCLUSION

Vitreoretinal interface pathology in pathologic myopia with posterior staphyloma encompasses a spectrum of conditions whose baseline functionality, prognosis, rate, and amount of progression vary significantly. Customized treatment for each different condition should be considered.

Authors+Show Affiliations

G.B. Bietti Eye Foundation-IRCCS, Rome, Italy. g.ripandelli@email.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

22614742

Citation

Ripandelli, Guido, et al. "Macular Vitreoretinal Interface Abnormalities in Highly Myopic Eyes With Posterior Staphyloma: 5-year Follow-up." Retina (Philadelphia, Pa.), vol. 32, no. 8, 2012, pp. 1531-8.
Ripandelli G, Rossi T, Scarinci F, et al. Macular vitreoretinal interface abnormalities in highly myopic eyes with posterior staphyloma: 5-year follow-up. Retina (Philadelphia, Pa). 2012;32(8):1531-8.
Ripandelli, G., Rossi, T., Scarinci, F., Scassa, C., Parisi, V., & Stirpe, M. (2012). Macular vitreoretinal interface abnormalities in highly myopic eyes with posterior staphyloma: 5-year follow-up. Retina (Philadelphia, Pa.), 32(8), 1531-8. https://doi.org/10.1097/IAE.0b013e318255062c
Ripandelli G, et al. Macular Vitreoretinal Interface Abnormalities in Highly Myopic Eyes With Posterior Staphyloma: 5-year Follow-up. Retina (Philadelphia, Pa). 2012;32(8):1531-8. PubMed PMID: 22614742.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Macular vitreoretinal interface abnormalities in highly myopic eyes with posterior staphyloma: 5-year follow-up. AU - Ripandelli,Guido, AU - Rossi,Tommaso, AU - Scarinci,Fabio, AU - Scassa,Cecilia, AU - Parisi,Vincenzo, AU - Stirpe,Mario, PY - 2012/5/23/entrez PY - 2012/5/23/pubmed PY - 2012/12/10/medline SP - 1531 EP - 8 JF - Retina (Philadelphia, Pa.) JO - Retina (Philadelphia, Pa.) VL - 32 IS - 8 N2 - PURPOSE: To review prevalence, long-term progression, and prognosis of vitreoretinal interface modifications in pathologic myopia with posterior staphyloma and investigate foveal sensitivity and fixation stability. METHODS: Retrospective single-institution series of 214 eyes (116 patients) with pathologic myopia, axial length >30 mm, and posterior staphyloma. Exclusion criteria included follow-up less than five years, incomplete records, and/or less than three optical coherence tomography or microperimetry. Patients were divided into 5 groups according to optical coherence tomography: 1) epiretinal membrane without schisis (ERM); 2) macular retinal schisis (Schisis); 3) partial thickness macular hole (PTMH); 4) full-thickness macular hole (FTMH); and 5) posterior retinal detachment (PRD) with or without macular hole. Disease progression was defined as a visual acuity decrease of two or more lines associated to objective worsening of the optical coherence tomography and/or microperimetry. RESULTS: Vitreoretinal abnormalities at baseline were present in 116 of 204 patients (56.8%) and 214 of 408 eyes (52.4%); 98 of 116 patients (84.4%) showed bilateral involvement. Baseline visual acuity and foveal sensitivity varied significantly with ERM performing better and PRD worse than others; PTMH and FTMH did not differ. During the 66 months of average follow-up, 33 of 214 eyes (15.4%) required surgery and 13 of 33 eyes (39.3%) needed reintervention. Surgery rate significantly differed among groups: 2% for ERM, 20% to 25% for Schisis, PTMH, and FTMH, and up to 50% for PRD. Progression rate of Schisis and FTMH was the same, regardless of symptoms, while macula-off PRD always required surgery. Decrease of fixation stability and foveal sensitivity correlated to need for surgery, while baseline foveal sensitivity and fixation did not. CONCLUSION: Vitreoretinal interface pathology in pathologic myopia with posterior staphyloma encompasses a spectrum of conditions whose baseline functionality, prognosis, rate, and amount of progression vary significantly. Customized treatment for each different condition should be considered. SN - 1539-2864 UR - https://www.unboundmedicine.com/medline/citation/22614742/Macular_vitreoretinal_interface_abnormalities_in_highly_myopic_eyes_with_posterior_staphyloma:_5_year_follow_up_ L2 - http://dx.doi.org/10.1097/IAE.0b013e318255062c DB - PRIME DP - Unbound Medicine ER -